P-THER-20: Biliary derivation by endoscopic ultrasound from gastric body in a patient with subtotal gastrectomy by gastric cancer

We present a biliary derivation from the gastric body in a patient with subtotal gastrectomy and anastomosis type Billroth I. The patient had a tumor obstruction of distal coledoco. The patient was with ictericia and the examinations indicated obstructive patron. A gastric transluminal derivation is made to common hepatic. Steps are as given below: 1. Endosonography that locates the tumor obstruction of the coledoco shows the dilated hepatic conduct; 2. Doppler signals are made that discharge vessels in the puncture route; 3. The punction was made in gastric body with endosonographic window direct to the dilated common hepatic conduct. The puncton is performed with Boston Scientific 19-gauge needle; 4. Bile was aspirated and contrast was injected to delineate the anatomy; 5. We pass a hydrophilic guide of W. Cook 0.035 mm and after introduce a cystotomy of 6 Fr; 6. Dilated the track is passed an autoexpandible stent covered of 60/10 mm. Patient evolves satisfactorily.